There is no California vaccine mandate that applies to the general public. What the state does have is a set of targeted rules: strict immunization requirements for children entering school or childcare, workplace policies that individual employers can adopt, and residual public health authority the state can use in high-risk settings. Whether you can refuse a vaccine, and what happens if you do, depends entirely on which of those situations you are in.
The COVID-19 orders that once required vaccination for healthcare workers and many other groups have been rescinded. County and city health departments can still adopt stricter local rules, so your city’s public health department is the right place to confirm anything specific to where you live.
What California Requires for Children in School
California’s childhood vaccination rules are among the strictest in the country. Under Health and Safety Code Section 120335, no child can be unconditionally admitted to a public or private school, childcare center, or nursery without documented immunization against a specific list of diseases.1California Legislative Information. California Health and Safety Code 120335
The required vaccines are:
- Diphtheria, tetanus, and pertussis (DTaP): 5 doses, with reduced requirements if certain doses were given after the 4th birthday
- Polio: 4 doses
- Measles, mumps, and rubella (MMR): 2 doses, both given on or after the 1st birthday
- Hepatitis B: 3 doses at first admission, but not required to advance to 7th grade
- Varicella (chickenpox): 2 doses
- Haemophilus influenzae type b (Hib): required by the statute, with doses depending on the child’s age
Students entering 7th grade must also receive at least one dose of Tdap, the pertussis booster typically given around age 11.2California Department of Public Health. Shots Required for TK-12 and 7th Grade
COVID-19 is not on the list. Although Governor Newsom announced in 2021 that the state intended to add it, that never happened, and CDPH has not used its authority to add it.
The school immunization requirements do not apply to children in home-based private schools or to independent study students who don’t receive classroom instruction.1California Legislative Information. California Health and Safety Code 120335
Personal Belief and Religious Exemptions No Longer Exist for School
California eliminated personal belief and religious exemptions for required childhood vaccines when SB 277 took effect in 2016. A medical exemption is now the only route to skip a required school vaccine. That has been the law for nearly a decade, and nothing about it has softened.
Getting a Medical Exemption Through CAIR-ME
Since January 1, 2021, medical exemptions must go through the California Immunization Registry Medical Exemption system, known as CAIR-ME. It is the only method schools can accept, and it was created by SB 276 specifically to curb the fraudulent exemptions that spiked after SB 277 closed the personal belief option.3California Legislative Information. Senate Bill 276
The process: a parent creates a CAIR-ME account, applies for an exemption, and receives a request number. The child’s physician, who must be a California-licensed MD or DO, then reviews the request, examines the child, and either issues or denies the exemption through the system. If issued, the physician prints the form and gives a copy to the parent, who submits it to the school.4California Department of Public Health. Exemption FAQs Temporary exemptions are valid for no more than 12 months. CDPH can review exemptions and revoke those that don’t meet established medical criteria.
Healthcare Workers
Healthcare workers were subject to the state’s strictest COVID-19 rules. In August 2021, the State Public Health Officer ordered all workers in hospitals, skilled nursing facilities, and other licensed healthcare settings to be fully vaccinated, with only narrow medical or religious exemptions.
CDPH rescinded that order effective April 3, 2023.5California Department of Public Health. Order of the State Public Health Officer Health Care Worker Vaccine Requirement The parallel federal requirement from the Centers for Medicare and Medicaid Services was withdrawn through a final rule effective August 4, 2023.6Federal Register. Medicare and Medicaid Programs Policy and Regulatory Changes to the Omnibus COVID-19 Health Care Neither is currently in effect.
Individual healthcare employers can still adopt their own vaccination policies, and the Cal/OSHA Aerosol Transmissible Diseases standard requires hospitals, skilled nursing facilities, clinics, home health agencies, and similar employers to offer recommended vaccines, including seasonal influenza, at no cost to workers with occupational exposure.7California Code of Regulations. Title 8, Section 5199 – Aerosol Transmissible Diseases Workers can decline, but the employer must document the offer and the declination.
When Your Employer Requires a Vaccine
Private employers in California can lawfully require vaccination as a condition of employment. Both the California Civil Rights Department and the U.S. Equal Employment Opportunity Commission have confirmed this, provided the policy clearly defines who is covered.8California Civil Rights Department. DFEH Employment Information on COVID-19
The policy cannot discriminate against employees based on any characteristic protected under the Fair Employment and Housing Act, including disability and religion. Vaccination status is confidential medical information under both the ADA and California’s Confidential Medical Information Act, so it must be stored separately from ordinary personnel files. Your employer can ask for proof of vaccination, and in exchange must engage in an interactive process with any employee who requests an exemption on disability or religious grounds.
Disability-Based Exemptions
If a medical condition prevents you from being vaccinated, your employer must engage in a timely, good-faith interactive process to identify a reasonable accommodation.9California Legislative Information. California Government Code 12940 You will usually need documentation from a healthcare provider describing the reason. Your employer can request supporting medical documentation, but the request must be limited to information relevant to the accommodation.10U.S. Equal Employment Opportunity Commission. What You Should Know About COVID-19 and the ADA, the Rehabilitation Act, and Other EEO Laws
Possible accommodations include remote work, regular testing, modified duties, physical distancing, or reassignment to a lower-exposure position. The employer isn’t required to grant your preferred accommodation, only one that is effective, unless doing so would cause undue hardship.8California Civil Rights Department. DFEH Employment Information on COVID-19
Religion-Based Exemptions
If vaccination conflicts with a sincerely held religious belief, you can request accommodation under FEHA and Title VII of the federal Civil Rights Act. Employers should generally assume the request is sincere, though they can make a limited inquiry if they have an objective reason to doubt it.10U.S. Equal Employment Opportunity Commission. What You Should Know About COVID-19 and the ADA, the Rehabilitation Act, and Other EEO Laws
The belief doesn’t need to be part of an organized religion, but it does need to be genuinely religious. Objections rooted in politics, personal preference, or general concerns about side effects do not qualify. That distinction is where most religious exemption requests fail.
Under FEHA, an employer must explore every available alternative before claiming undue hardship. The statute specifically references excusing the employee from conflicting duties, allowing the duties to be performed at another time, or having someone else cover them.9California Legislative Information. California Government Code 12940
How Fast Your Employer Has to Respond
Neither FEHA nor the ADA sets a hard deadline in days for the interactive process, but federal guidance requires employers to respond expeditiously. Unnecessary delay can itself violate the law; the EEOC has cited a two-month period of inaction on a simple accommodation request as an example.11U.S. Equal Employment Opportunity Commission. Enforcement Guidance on Reasonable Accommodation and Undue Hardship Under the ADA Silence isn’t a safe response for an employer.
Colleges and Universities
The University of California and California State University systems set their own immunization policies and have more flexibility than K-12 schools. During the pandemic, most UC and CSU campuses required COVID-19 vaccination. Those policies have shifted. COVID-19 vaccination remains a local requirement at some campuses, meaning it varies by institution rather than being system-wide.12California Department of Public Health. Immunization Recommendations and Screening Requirements for Colleges Check directly with the student health office at your campus. Private colleges set their own rules and can be stricter than public institutions.
Filing a Complaint if Your Exemption is Denied
If your employer denies your request without engaging in the interactive process, retaliates against you for asking, or terminates you without considering alternatives, you can pursue a formal complaint.
At the state level, file with the California Civil Rights Department. The deadline for employment discrimination claims is three years from the date you were last harmed.13California Civil Rights Department. Complaint Process The process starts with an intake form; a CRD representative then evaluates whether the complaint can be accepted for formal investigation. Gather documentation of your accommodation request, the employer’s response (or lack of one), and any medical records that support your claim. To file your own lawsuit instead, you must first obtain a Right-to-Sue notice from CRD.14California Civil Rights Department. Employment Discrimination
At the federal level, file a charge of discrimination with the EEOC. Because California has its own anti-discrimination law and enforcement agency, the filing deadline is 300 calendar days from the discriminatory act.15U.S. Equal Employment Opportunity Commission. How to File a Charge of Employment Discrimination The CRD and EEOC share filings under a worksharing agreement, so filing with one preserves your rights with the other.
Fake Vaccination Cards Carry Real Prison Time
Buying, creating, or using a counterfeit vaccination card is a federal crime. Prosecutors have charged individuals under fraud and conspiracy statutes for trafficking in fake CDC vaccination cards. In one case, a defendant who sold approximately 120,000 fake COVID-19 vaccination cards was sentenced to 12 months in federal prison, three years of supervised release, and a $40,000 fine.16United States Department of Justice. Utah Fraudster Sentenced for Selling 120,000 Fake COVID-19 Vaccination Record Cards A pursued medical or religious exemption is the lawful path; a fake card is not.